2 Anestetik
2.1 Anestetik Lokal
1. Etil Klorida semprot 100 ml
2. Lidocain inj infiilr 1% (HCl0 ktk 100 amp @ 2ml
inj 2 % (HCl0 ktk 100 amp @ 2ml
Jeli 2%, tube 10 g
semprot 4 % btl 50 ml
6.2.2
2.2 Anestetik Umum dan oksigen 6.2.2.1
1. Ketamin Inj iv. 10mg/ml (sbg HCl) ktk 10 vial @ 20 ml
Inj iv. 50mg/ml (sbg HCl) ktk 10 vial @ 20 ml
2. Oksigen ih, gas dlm tabung
3. Tiopental serb inj iv 500mg/amp (garam Na)
5 Antiepilepsi-Antikonvulsi
1. Diazepan inj im/iv 5mg/mlktk100 amp@2ml
lart rektal 4mg/ml tube 2,5ml
2. Fenitoin Kaps30mg (garam Na) ctl 250kaps
Kaps100mg (garam Na) ctl 250kaps
inj 50mg/ml (garam Na) ktk 10 amp @2ml
6.4 Antifungi
6.4.1 Antifungi Sistemik 12.3
1. Griseofulvin, Mironized tab scored 250mg, btl100 tab
2. Nistatin tab salut 500.000UI/tab, btl 100/1000 tab
susp 100.000UI/ml, btl 12 ml 13
13.1
6.4.2 Antifungi, Topical
1. Antifungi Doen salep, pot 30g
- Asam benzoat 6%
- Asam saliilat 3% 13.2
2. Nistatin tab salut 500.000UI/tab, btl 100/1000 tab
6.5 Antiprotozoa
6.51 Antiamuba dan Antigiardiasis
1. Metronidazol tab 250mg. Btl 100/1000 tab
tab 500mg. Btl 100/1000 tab
14
6.5.2 Antimalaria 14.1
6.5.2.1 Untuk Pencegahan
1. Klorokuin tab 150 mg (sbg fosfat), btl 1000 tab
15 Diuretik
1. Furosemida tab 40mg, ktk 10str @ 10 tab 18.4
inj iv/im 10mg/ml, ktk 25 amp@ 2ml
17.2 Antiaritmia
1 Propanolol tab 10 mg, ktk 10 str @ 10 tab
inj iv 1mg/ml(HCl), ktk 10 amp @ 1ml
17.8 Antihipelipidemia
1 Simvastatin tab 10 mg, ktk 10 str @ 10 tab
23.3 Antiobsesi
1 Haloperidol tab 0,5mg, ktk 10bls@10 tab (100/1000)
tab 1,5mg, ktk 10bls@10 tab (100/1000) 26.3
tab 2 mg, ktk 10bls@10 tab
tab 5 mg, ktk 10bls@10 tab
tts 2 mg/ml, btl15ml/100ml
inj im2mg/ml (HCl)ktk 5amp@1ml
inj im5mg/ml (HCl)ktk 5amp@1ml
inj 50mg/ml(dekanoat ktk5amp@1ml (long acing) 27
2 klorpromazin tab salut 25mg (HCl), btl 1000 tab 27.1
tab salut 100mg (HCl), btl 1000 tab
inj im 25mg/ml(HCl), ktk 100 amp @1 ml
25.3 Antihermoroid
1 Antihermoroid Doen sup, ktk 100 sup
- Bismut Subgalat 150mg
- Heksaklorofen 2,5mg
- lidokain 10 mg
- Seng Oksida 120mg 28
- Sup ad2g
25.4 Antispasmodik 29
1 Atropin tab 1mg(sulfat) btl 100 tab
inj im/iv/sk 0,25mg/ml (sulfat)ktk 100 amp@ 1ml
inj im/iv/sk 1mg/ml (sulfat)ktk 50 amp@ 1ml
2 Ekstrak Beladon tab 10mg \, btl100/1000 tab
25.6 Katartik
1 Gliserin cairan 100ml
26 Saluran Napas Obat untuk
26.1 Antiasma
1. Deksametason tab 0,5mg, btl 1000 tab
inj 5mg/ml (sbg Na Fosfat), ktk 100
2 Efedrin tab 25mg (HCl), btl 1000 tab
3 Epinerfrin (adrenalin) inj 0,1% (sbg Hcl/Bitartat), ktk 100 amp @1ml
4 Salbutamol tab 2mg(sbg Sulfat) ktk 10blt @ 10 tab
tab 4mg(sbg Sulfat) ktk 10blt @ 10 tab
KELAS TERAPI, NAMA FORMULASI
GENERIK (Bentuk Sediaan, Kekuatan dan
Kemasan)
3. Fenorbarbital tab 30mg, btl 1000 tab
tab 50mg, btl 1000 tab
tab 100mg, btl 1000 tab
inj iv. 50mg/ml, ktk 100amp@2ml
inj iv. 50mg/ml, (sbg Garam Na), Ktk 100
Antiinfeksi
Antelmintik
Antelmintik Intestinal
1. Mebendazol tab 100mg, btl 100 tab
sir 100 mg/5ml btl 30 ml
2. Piratel tab scored 250mg (sbg pamoat) btl 1000 tab
susp 125mg/5ml (sbg pamoat) btl 30ml
Antifilaria
1. Dietilkarbamazin tab scored 100mg (sbg sitrat) btl 1000 tab
Antibakteria
Beta Laktam
1. Amoksilin trihidrat tab scored 500mg ktk 10 str@ 10 tab
sir kering 125 mg/5ml btl 60 ml
2. Ampicillin serb inj im/iv 250mg/vial( sbg garam Na)
serb inj im/iv 500mg/vial( sbg garam Na)
3. Benzatin Benzilpenisillin inj im 1.2jutaUI/ml, ktk 25 vial @4ml
inj im 2.4jutaUI/ml, ktk 25 vial @10ml
4. Benzilpenisillin Kristal inj im/iv 10juta UI/vial ktk 25 vial
5. Fenoksimetil Penisillin (Penisillin V) tab 500mg(sbg garam K), btl 1000tab
tab2 50mg(sbg garam K), ktk 10 stp@ 10 tab
Antibiotik Lain
Tetrasiklin
1. Oksitetrasiklin inj iv 250mg/3ml (HCl) ktk 10 amp @ 3ml
inj iv 500mg/3ml (HCl) ktk 10 amp @ 10ml
2. Tetrasiklin kap 250mg(HCl), btl 1000 kap
kap 500mg(HCl), ktk 10 stp @ 10 tab
Klorampenicol
1. Klorampenicol kap 250mg, btl 1000 kap
sups 125/5ml (sbg etil suksnat), btl 60 ml
Sulfa-Trimetoprim
1. Kontrimoksazol DOEN I (dewasa) tab, ktk 10 str @ 10 Tab
- Sulfametoksazol 400 mg
- Trimetoprim 80 mg
2. Kontrimoksazol DOEN II (pediatrik) tab, btl 100 tab
- Sulfametoksazol 100 mg
- Trimetoprim 20 mg
3. Sulfadiazin tab 500 mg, btl 100 tab
4. Trimetoprin tab scored 200mg, btl 100 tab
Makrolid
1. Eritromisin kap 250mg (sbg sterarat), btl 100 kap
sir200mg/5ml (sbg suksinat), btl 60 ml
Penggunaan Khusus
1. Metronidazol tab 250mg. Btl 100/1000 tab
tab 500mg. Btl 100/1000 tab
Antiinfeksi Khusus
Antilepra
1. Dapson tab scored 100mg. Btl 1000 tab
2. Klofazimin, Micronized kap dlm minyak 100mg, btl 100 kap
Diagnotik
Tes Fungsi
Lain-lain
1. Fluoresein tts mata 1% (garam Na), btl 5ml
tts mata 2% (garam Na), btl 5ml
inj 10, ktk 1 amp 5ml
inj 20, ktk 1 amp 5ml
Tes Kulit
1. Tuberkulin Protein Purified Derivative inj ik 1 : 10, ktk @ vial 2 ml
Disinfektan
1. Etanol 70% lar, btl 100ml/1000ml
2. Kalsium Hipoklorit serb, ktg 20g
3. Kresol Tersaponifikasi 50% (lisol) Cairan, btl 1000ml
4. Paraformaldehida tab 1g, btl 100 tab
lar 5%, btl 1000ml
Kaustik
1 Perak Nitrat lart 20 %, btl 10 ml
Lain-lain
1 Bedak salisil serbk 25 ktk 100 g
2 Liquor Carbonis Detergens susp 2%, btl 30ml
susp 5%, btl 30ml
3 Liquor Faberi Liquor
Lain-lain
Air untuk Injeksi ktk. Amp/vial @10ml/20ml
Antimiroba
1 Oksitetrasiklin salep mata 1% (HCl), tube 3,5g
2 Sulfasetamida tts mata 15 % (natrium), btl 5ml
Midriatik
1. Atropin tts mata0,5 % ((sulfat), btl 5ml
tts mata1% (sulfat) btl 5ml
Psikofarmaka
Antiantesietas dan Antiinsomnia
1 Diazepam tab 2mg, btl 1000 tab
tab 5mg, btl 1000 tab
inj im 5mg/ml, ktk 100@2ml
Ekspektoran
1 Gliseril Guaiakolat sir 25mg/ml btl, 60ml
tab 100mg , btl 1000 tab
2 Obat Batuk Hitam (OBH) cairan, btl 200ml
cairan konsentrat, btl 1000ml
Vaksin
1 Vaksin BCG inj ik, ktk 5 amp@2ml
inj ik, ktk 5 amp@5ml
2 Vaksin Campak inj sk, ktk 10 vial (10dosis) @ 5ml
3 Vaksin Hepatitis B Rekombinan inj 20mcg/ml, ktk 1 vial 0,5; 1 ml
4 Vaksin Jerap Difetri Tetanus (DT) inj im,ktk 10vial @ 5ml
5 Vaksin Jerap Difetri Tetanus Pertusis inj im,ktk 10vial @ 5ml
6 Vaksin Jerap Tetanus(Tetanus) inj im ktk 1 vial 5 ml
7 Vaksin Polia tts, ktk vial 10/20 dosis
8 Vaksien rabies untuk Manusia serb inj sk/ik, ktk 7 vial @ 1 dosis + 7 amp plr
Booster : ktk 5 amp 1 dosis + 5amp pelarut
2 Anestetik
2.1 Anestetik Lokal
1. Etil Klorida semprot 100 ml
2. Lidocain inj infiilr 1% (HCl0 ktk 100 amp @ 2ml
inj 2 % (HCl0 ktk 100 amp @ 2ml
Jeli 2%, tube 10 g
semprot 4 % btl 50 ml
5 Antiepilepsi-Antikonvulsi
1. Diazepan inj im/iv 5mg/mlktk100 amp@2ml
lart rektal 4mg/ml tube 2,5ml
2. Fenitoin Kaps30mg (garam Na) ctl 250kaps
Kaps100mg (garam Na) ctl 250kaps
inj 50mg/ml (garam Na) ktk 10 amp @2ml
6 Antiinfeksi
6.1 Antelmintik
6.1.1 Antelmintik Intestinal
1. Mebendazol tab 100mg, btl 100 tab
sir 100 mg/5ml btl 30 ml
2. Piratel tab scored 250mg (sbg pamoat) btl 1000 tab
susp 125mg/5ml (sbg pamoat) btl 30ml
6.1.2 Antifilaria
1. Dietilkarbamazin tab scored 100mg (sbg sitrat) btl 1000 tab
6.2 Antibakteria
6.2.1 Beta Laktam
1. Amoksilin trihidrat tab scored 500mg ktk 10 str@ 10 tab
sir kering 125 mg/5ml btl 60 ml
serb inj im/iv 1000mg/vial( sbg garam Na)
2. Ampicillin serb inj im/iv 250mg/vial( sbg garam Na)
serb inj im/iv 1000mg/vial( sbg garam Na)
3. Benzatin Benzilpenisillin inj im 1.2jutaUI/ml, ktk 25 vial @4ml
inj im 2.4jutaUI/ml, ktk 25 vial @10ml
4. Benzilpenisillin Kristal inj im/iv 10juta UI/vial ktk 25 vial
5. Fenoksimetil Penisillin (Penisillin V) tab 500mg(sbg garam K), btl 1000tab
tab2 50mg(sbg garam K), ktk 10 stp@ 10 tab
5 Amoxyclav tab scored 500mg ktk 10 str@ 10 tab
sir kering 125 mg/5ml btl 60 ml
6.2.2.2 Klorampenicol
1. Klorampenicol kap 250mg, btl 1000 kap
sups 125/5ml (sbg etil suksnat), btl 60 ml
6.2.2.3 Sulfa-Trimetoprim
1. Kontrimoksazol DOEN I (dewasa) tab, ktk 10 str @ 10 Tab
- Sulfametoksazol 400 mg
- Trimetoprim 80 mg
2. Kontrimoksazol DOEN II (pediatrik) tab, btl 100 tab
- Sulfametoksazol 100 mg
- Trimetoprim 20 mg
3. Sulfadiazin tab 500 mg, btl 100 tab
4. Trimetoprin tab scored 200mg, btl 100 tab
6.2.2.4 Makrolid
1. Eritromisin kap 250mg (sbg sterarat), btl 100 kap
sir200mg/5ml (sbg suksinat), btl 60 ml
6.2.2.5 Cephalosporin
Cefadroxyl tab scored 500mg ktk 10 str@ 10 tab
sir kering 125 mg/5ml btl 60 ml
6.2.2.7 Penggunaan Khusus
1. Metronidazol tab 250mg. Btl 100/1000 tab
tab 500mg. Btl 100/1000 tab
6.3 Antiinfeksi Khusus
6.3.1 Antilepra
1. Dapson tab scored 100mg. Btl 1000 tab
2. Klofazimin, Micronized kap dlm minyak 100mg, btl 100 kap
6.3.2 Antitubeekulosis
1. Etambutol tab 250mg (HCl), btl100 tab
tab 500mg (HCl), btl100 tab
2. Isoniazid tab 100mg , btl 1000 tab
tab 300mg , btl 1000 tab
3. Pirazinamid tab 500mg , btl100 tab
4. Rifampisin tab 300mg , ktk 10 str@ 10 tab
tab 450mg , ktk 10 str@ 10 tab
tab 600mg , ktk 10 str@ 10 tab
5. Streptomisin serb inj 1000mg/vial (sbg sulfat), ktk 100 vial
6. Kombinasi
- Rimfampisin Kap 150mg; 75mg
- Isoniazid tab 150mg; 50mg
7. Kambinasi
- Rimfampisin Kap 150mg; 75mg; 450mg
- Isoniazid tab 150mg; 50mg; 300mg
- Pirazinamid tab 400mg; 150mg; 500mg
8. Kambinasi
- Rimfampisin kap 150mg
- Isoniazid tab 150mg
- Etambutol tab 400mg'
9. Kambinasi
- Rimfampisin Kap 150mg; 450mg
- Isoniazid tab 150mg; 300mg
- Pirazinamid tab 400mg; 500mg
- Etambutol tab 400mg; 250mg; 500mg
6.5.2 Antimalaria
6.5.2.1 Untuk Pencegahan
1. Klorokuin tab 150 mg (sbg fosfat), btl 1000 tab
7 Antimigren
7.1 Profilasis
1. Dihidroergotamin tab 2.5mg(sbg Mesilat), ktk 10str @ 10 tab
7.2 Serangan Akut
1. Ergometri tab1mg (tatrat), btl 100tab
2. Kombinasi tab, ktk 30/100tab
- Ergometri 1mg
- Kafein 50mg
9 Antiparkison tab,btl 100 tab
1. Antiparkison Doen
- Benserazid 25mg
- Levodopa 100mg
2. Triheksifenidil tab 2mg (HCl), ktk 10 str @ 10 tab
12 Diagnotik
12.2 Tes Fungsi
12.2.3 Lain-lain
1. Fluoresein tts mata 1% (garam Na), btl 5ml
tts mata 2% (garam Na), btl 5ml
inj 10, ktk 1 amp 5ml
inj 20, ktk 1 amp 5ml
12.3 Tes Kulit
1. Tuberkulin Protein Purified Derivativ inj ik 1 : 10, ktk @ vial 2 ml
13.2 Disinfektan
1. Etanol 70% lar, btl 100ml/1000ml
2. Kalsium Hipoklorit serb, ktg 20g
3. Kresol Tersaponifikasi 50% (lisol) Cairan, btl 1000ml
4. Paraformaldehida tab 1g, btl 100 tab
lar 5%, btl 1000ml
15 Diuretik
1. Furosemida tab 40mg, ktk 10str @ 10 tab
inj iv/im 10mg/ml, ktk 25 amp@ 2ml
16.5 Kortikosteroid
1. Deksametason tab 0,5mg, btl 1000 tab
inj 5mg/ml (sbg Na Fosfat), ktk 100
2 Hidrokortison tab 10 mg
serb inj 100mg/vial (Na Suksinat) ktk 100 vial @ ml
3 Prednison Tab 5mg, btl 1000mg
17 Kardiovaskuler, obat
17.1 Antiagina
1 Atenolol tab 50 mg, ktk 10 str @ 10 tab
2 Isosorbid Dinitrat tab subligual 5mg, ktk 10 str @ 10 tab
17.2 Antiaritmia
1 Propanolol tab 10 mg, ktk 10 str @ 10 tab
inj iv 1mg/ml(HCl), ktk 10 amp @ 1ml
17.3 Antihipertensi
1 Hidroklorotiazida tab 25 mg mg, btl 1000 tab
2 Kaptropil tab 12,5 mg, ktk 10 str @ 10 tab
tab 25 mg, ktk 10 str @ 10 tab
18.2 Antibakteri
1 Antibakteri Doen salep, tube 5 g
- Basitrasin 500 IU/g
- Poliiksin B 10.000 IU/g
18.3 Antifungi
1. Antifungi Doen salep, pot 30g
- Asam benzoat 6%
- Asam saliilat 3%
2 Natrium Tiosulfat cairan 25%(asetat), tube 5g
18.6 Kaustik
1 Perak Nitrat lart 20 %, btl 10 ml
18.8 Lain-lain
1 Bedak salisil serbk 25 ktk 100 g
2 Liquor Carbonis Detergens susp 2%, btl 30ml
susp 5%, btl 30ml
3 Liquor Faberi Liquor
20 Larutan elektrolit, Nutisi dan lain-lain
20.1 Oral
1 Garam Oralit Serb 100ktg@ktg untuk 200 Ml air
- Natrium Klorida 0,52 g
- Kalium Klorida 0,30g
- Trinatrium Sitrat Dihidrat 0,58g
- Glukosa Anhidrat 2,70g
20.2 Parenteral
1 Glulosa lar infus 5%, btl 500 ml
lar infus 10%, btl 500 ml
lar infus 40%, btl 500 ml
2 Natrium Klorida lar infus 0,9%, btl 500 ml
lar infus 3%, btl 500 ml
inj 15%, vial 50ml
3 Ringer Laktat lar infus , btl 500 ml
20.3 Lain-lain
Air untuk Injeksi ktk. Amp/vial @10ml/20ml
21.2 Antimiroba
1 Oksitetrasiklin salep mata 1% (HCl), tube 3,5g
2 Sulfasetamida tts mata 15 % (natrium), btl 5ml
21.4 Midriatik
1. Atropin tts mata0,5 % ((sulfat), btl 5ml
tts mata1% (sulfat) btl 5ml
23 Psikofarmaka
23.1 Antiantesietas dan Antiinsomnia
1 Diazepam tab 2mg, btl 1000 tab
tab 5mg, btl 1000 tab
inj im 5mg/ml, ktk 100@2ml
supp 5mg 2,5ml
supp 10mg 2,5ml
23.3 Antiobsesi
1 Haloperidol tab 0,5mg, ktk 10bls@10 tab (100/1000)
tab 1,5mg, ktk 10bls@10 tab (100/1000)
tab 2 mg, ktk 10bls@10 tab
tab 5 mg, ktk 10bls@10 tab
tts 2 mg/ml, btl15ml/100ml
inj im2mg/ml (HCl)ktk 5amp@1ml
inj im5mg/ml (HCl)ktk 5amp@1ml
inj 50mg/ml(dekanoat ktk5amp@1ml (long acing)
2 klorpromazin tab salut 25mg (HCl), btl 1000 tab
tab salut 100mg (HCl), btl 1000 tab
inj im 25mg/ml(HCl), ktk 100 amp @1 ml
25.2 Antiemetik
1 Dimenhidrinat tab 50mg, btl 1000 tab
2 Klorpromazin tab salut 25 mg (HCl), btl 1000 tab
inj 25mg/ml (HCl), ktk 100 amp@1ml
inj 5mg/ml (HCl), ktk 100 amp@2ml
3. Domperidon tablet 10mg,ktk 100 tab
4. Metoclopramid tablet 10mg,ktk 100 tab
injeksi 5mg/ml
2. Codein
2 2. Anestetik 2 Anestetik
2.1 2.1 Anestetik Lokal 2 1 Anestetik Lokal
1 Etil Klorida semprot 100 ml 1 Etil Klorida
2 Lidocain inj infiilr 1% (HCl0 ktk 100 amp @ 2ml 2 Lidocain
inj 2 % (HCl0 ktk 100 amp @ 2ml
Jeli 2%, tube 10 g
semprot 4 % btl 50 ml
2.2 2.2 Anestetik Umum dan oksigen 2 2 Anestetik Umum dan oksigen
1 Ketamin Inj iv. 10mg/ml (sbg HCl) ktk 10 vial @ 20 ml 1 Ketamin
Inj iv. 50mg/ml (sbg HCl) ktk 10 vial @ 20 ml
2 Oksigen ih, gas dlm tabung 2 Oksigen
3 Tiopental serb inj iv 500mg/amp (garam Na) 3 Tiopental
2.3 2.3 Prosedur Pre Oreatif, Obat Untuk 2 3 Prosedur Pre Oreatif, Obat Untuk
1. Atropin inj 1 mg/ml (sulfat), ktk 50 amp @ 1ml 1. Atropin
2. Diazepam tab 5 mg/ 1000 tablet btl 2. Diazepam
inj 5 mg/ml , ktk 100 amp @ 2ml
3. Morpin inj im/s.k.iv 1 mg/ml (sulfat), ktk 10 amp @ 1ml 3. Morpin
3 3. Antialergi dan Obat Untuk Anafilaksis 3 Antialergi dan Obat Untuk Anafilaksis
1. Deksametason inj 5mg/ml (Natrium Fosfat)/ ktk 100 1. Deksametason
2. Difenhidramin inj. Im 10mg/ml (HCl)/ ktk 100 amp @1ml 2. Difenhidramin
3. Epinefrin (adrenalin) inj im/s.k.iv 0,1 % mg/ml (sulfat), ktk 10 0amp 3. Epinefrin (adrenalin)
4. Klorfeniramin tab 4mg (maleat) btl/ 1000 4. Klorfeniramin
inj 5mg/ml (Maleat)/ ktk 100 2 1ml
4 4. Antidot dan Obat lain Keracunan 4 Antidot dan Obat lain Keracunan
4.1 4.1 Khusus 4 1 Khusus
1. Atropin inj im/iv/sk 1 mg/ml (sulfat), ktk 50 amp @ 2ml 1. Atropin
2. Kalsium Folimat (Leukovorin Ca) tab 500mg /btl 1000 tab 2. Kalsium Folimat (Leukovorin Ca)
3. Natrium Bikarbonat tab 500mg /btl 1000 tab 3. Natrium Bikarbonat
4. Natrium Tiosulfat inhiv. 25% ktk10@10ml 4. Natrium Tiosulfat
4.2 4.2 Umum 4 2 Umum
1. Karbon Aktif Serbuk Aktif, ktg 0,5kg 1. Karbon Aktif
2. Magnesium Sulfat Ser, ktg 30g 2. Magnesium Sulfat
5 5. Antiepilepsi-Antikonvulsi 5 Antiepilepsi-Antikonvulsi
1. Diazepan inj im/iv 5mg/mlktk100 amp@2ml 1. Diazepan
lart rektal 4mg/ml tube 2,5ml
2. Fenitoin Kaps30mg (garam Na) ctl 250kaps 2. Fenitoin
Kaps100mg (garam Na) ctl 250kaps
inj 50mg/ml (garam Na) ktk 10 amp @2ml
3. Fenorbarbital tab 30mg, btl 1000 tab 3. Fenorbarbital
tab 50mg, btl 1000 tab
tab 100mg, btl 1000 tab
inj iv. 50mg/ml, ktk 100amp@2ml
inj iv. 50mg/ml, (sbg Garam Na), Ktk 100
6 6. Antiinfeksi 6 Antiinfeksi
6.1 6.1 Antelmintik 6 1 Antelmintik
6.1.1 6.1.1 Antelmintik Intestinal 6 1 1 Antelmintik Intestinal
1. Mebendazol tab 100mg, btl 100 tab 1. Mebendazol
sir 100 mg/5ml btl 30 ml
2. Pirantel tab scored 250mg (sbg pamoat) btl 1000 tab 2. Piratel
susp 125mg/5ml (sbg pamoat) btl 30ml
6.1.2 6.1.2 Antifilaria 6 1 2 Antifilaria
1. Dietilkarbamazin tab scored 100mg (sbg sitrat) btl 1000 tab 1. Dietilkarbamazin
6.2.2.2 Klorampenicol 6 2 2 2
1. Klorampenicol kap 250mg, btl 1000 kap
sups 125/5ml (sbg etil suksnat), btl 60 ml
6.2.2.3 Sulfa-Trimetoprim 6 2 2 3
1. Kontrimoksazol DOEN I (dewasa) tab, ktk 10 str @ 10 Tab
- Sulfametoksazol 400 mg
- Trimetoprim 80 mg
2. Kontrimoksazol DOEN II (pediatrik) tab, btl 100 tab
- Sulfametoksazol 100 mg
- Trimetoprim 20 mg
3. Sulfadiazin tab 500 mg, btl 100 tab
4. Trimetoprin tab scored 200mg, btl 100 tab
6.2.2.4 Makrolid 6 2 2 4
1. Eritromisin kap 250mg (sbg sterarat), btl 100 kap
sir200mg/5ml (sbg suksinat), btl 60 ml
6.2.2.7 Penggunaan Khusus 6 2 2 7
1. Metronidazol tab 250mg. Btl 100/1000 tab
tab 500mg. Btl 100/1000 tab
6.3 Antiinfeksi Khusus 6 3
6.3.1 Antilepra 6 2 1
1. Dapson tab scored 100mg. Btl 1000 tab
2. Klofazimin, Micronized kap dlm minyak 100mg, btl 100 kap
6.3.2 Antituberkulosis
7. Antimigren 7
7.1 Profilasis 7 1
1. Dihidroergotamin tab 2.5mg(sbg Mesilat), ktk 10str @ 10 tab
7.2 Serangan Akut 7 2
1. Ergometri tab1mg (tatrat), btl 100tab
2. Kombinasi tab, ktk 30/100tab
- Ergometri 1mg
- Kafein 50mg
9 Antiparkison tab,btl 100 tab 9
1. Antiparkison Doen
- Benserazid 25mg
- Levodopa 100mg
2. Triheksifenidil tab 2mg (HCl), ktk 10 str @ 10 tab
12 Diagnotik ###
12.2 Tes Fungsi ###2
12.2.3 Lain-lain ###2 3
1. Fluoresein tts mata 1% (garam Na), btl 5ml
tts mata 2% (garam Na), btl 5ml
inj 10, ktk 1 amp 5ml
inj 20, ktk 1 amp 5ml
12.3 Tes Kulit ###3
1. Tuberkulin Protein Purified Derivative inj ik 1 : 10, ktk @ vial 2 ml
15 Diuretik ###
1 Furosemida tab 40mg, ktk 10str @ 10 tab
inj iv/im 10mg/ml, ktk 25 amp@ 2ml
21.5 Miotik dan Antiglaukoma tts mata 2 % (HCl/Nitrat), btl 5ml ###5
1 Pilokarpin tts mata 4% (HCl/Nitrat) btl 5ml
23 Psikofarmaka ###1
23.1 Antiantesietas dan Antiinsomnia
1 Diazepam tab 2mg, btl 1000 tab
tab 5mg, btl 1000 tab
inj im 5mg/ml, ktk 100@2ml